Andresen David
Department of Microbiology, Centre for Kidney Research, Children's Hospital at Westmead, Sydney, Australia.
Paediatr Respir Rev. 2007 Sep;8(3):221-30. doi: 10.1016/j.prrv.2007.07.002. Epub 2007 Sep 6.
This article will review traditional and newer microbiological techniques for the diagnosis of mycobacterial respiratory infections. It will concentrate on the diagnosis of infections due to Mycobacterium tuberculosis, the main mycobacterium causing respiratory infections of clinical and public health importance. The diagnosis of respiratory disease associated with non-tuberculous mycobacteria (NTM), particularly in children with underlying airway pathology such as cystic fibrosis (CF) or bronchiectasis, will be briefly discussed. With respect to the diagnosis of tuberculosis (TB), the review will concentrate on the diagnosis of patients with symptoms and/or signs of clinical disease, rather than the detection of exposure or asymptomatic infection. It will not specifically address the assessment of pre-test probability based on clinical or epidemiological factors, the use of radiological investigations or the investigation of extrathoracic lymph node disease or chest wall disease. The role of newer diagnostic modalities including nucleic acid detection (NAD) and gamma-interferon assays in paediatric practice will be reviewed, and suggestions made as to how they may fit into contemporary diagnostic algorithms.
本文将综述用于诊断分枝杆菌呼吸道感染的传统及新型微生物学技术。它将聚焦于由结核分枝杆菌引起的感染的诊断，结核分枝杆菌是导致具有临床和公共卫生重要性的呼吸道感染的主要分枝杆菌。与非结核分枝杆菌（NTM）相关的呼吸道疾病的诊断，特别是在患有潜在气道病变（如囊性纤维化（CF）或支气管扩张）的儿童中，将进行简要讨论。关于结核病（TB）的诊断，综述将集中于有临床疾病症状和/或体征的患者的诊断，而非暴露或无症状感染的检测。它不会专门涉及基于临床或流行病学因素的检测前概率评估、放射学检查的使用或胸外淋巴结疾病或胸壁疾病的检查。将综述包括核酸检测（NAD）和γ-干扰素检测在内的新型诊断方法在儿科实践中的作用，并就它们如何适用于当代诊断算法提出建议。
